Faculty Bibliography

Ever since HIV, the virus that causes AIDS, was identified in the early 1980s, development of an AIDS vaccine has been the highest public health priority. Since 1984, the U.S. Public Health Service has spent at least $639 million on developing an AIDS vaccine. Empiricists say they must rely at least in part on intelligent guesswork. Scientists favoring a more cautious approach say the deadliness of AIDS means that as much as possible should be learned through laboratory and animal experiments before subjecting volunteers to the crucial test - finding out whether the vaccine prevents infection. The June panel, reviewing fresher data, learned that 13 participants in AIDS vaccine trials, including two in the Biocine and Genentech studies, had become infected with HIV. The infections came from risky behavior, not from the vaccine. Some infections are expected in vaccine trials. Because none of the newly infected participants had completed a full course of immunization (up to four shots over several months), their cases probably are not likely to be helpful in assessing the efficacy of the vaccines

Ever since H.I.V., the virus that causes AIDS, was identified in the early 1980's, development of an AIDS vaccine has been the highest public health priority. Since 1984, the United States Public Health Service has spent at least $639 million on developing an AIDS vaccine. Scientists are generally more cautious in testing a prevention method than they are concerning new therapies for a disease. But Dr. [Sten H. Vermund] argued that the risk-to-benefit ratio should tilt toward taking more risks in dealing with prevention for a major public health problem. In his opinion, the June panelists should have recommended forging ahead in testing the efficacy of the two experimental AIDS vaccines. 'In the face of a raging epidemic in which existing preventions have limited efficacy, why aren't we compelled to take more risks in prevention research?' he asked. 'AIDS has been wonderful for molecular biologists,' Dr. [Murray Gardner] said. 'But have molecular biologists done anything for AIDS yet?'

The AIDS Research Advisory Committee on Jun 17, 1994 rejected a proposal to conduct large-scale studies of the effectiveness of the two most-tested experimental AIDS vaccines. Instead, the panel recommended continuing smaller studies to test the safety of the vaccines and to evaluate the immune reaction to them

A congressional hearing was told on Jun 15, 1994 that the University of Pittsburgh's own auditors found serious problems at 10% of the hospitals it checked that carried out federally financed breast cancer studies, but the university professors conducting the studies failed to correct them in a timely and constructive manner

A dispute between the Journal of the American Medical Association and the journal Science, published by the American Association for the Advancement of Science, over the validity of findings in a published report about Kaposi's sarcoma is examined. Kaposi's sarcoma is a skin cancer that affects many AIDS patients. The dispute involves an experimental compound, sulfated polysaccharide-peptoglycan, that is believed by some to hold promise for treating the cancer

Two months after suspending entry of new patients into the University of Pittsburgh's flawed breast and rectal cancer studies, federal health officials on Jun 8, 1994 approved resumption of the trials on a limited basis. The breast cancer studies are intended to evaluate the effectiveness of tamoxifen and other chemotherapy for certain groups of patients who have developed breast cancer

The smallpox virus, which was targeted for destruction by Dec 31, 1993, will survive in freezers in Moscow and Atlanta for at least another year. Some scientists oppose the destruction of smallpox because they say study of the virus could yield useful medical knowledge about other diseases

Doctors have long arbitrarily divided lymphomas into two types: Hodgkin's disease and a dozen other forms grouped as non-Hodgkin's lymphomas. Hodgkin's disease is named for Thomas Hodgkin, a 19th century physician in London who distinguished the cancer from tuberculosis. The possibly infectious nature of lymphomas is reflected in their symptoms, including fever, fatigue and weight loss, which can mimic those produced by many infections. But most lymphomas are symptomless in their early stages. Usually, it is a painless swollen lymph node that leads a person to seek medical attention for a lymphoma, which is what happened with [Jacqueline Kennedy Onassis]. This year, 52,900 lymphoma cases (7,900 Hodgkin's and 45,000 non-Hodgkin's lymphoma) will be diagnosed in the United States. Nearly 23,000 of these patients are expected to die from the disease

In contrast to the earlier findings of the FDA, a report from an advisory committee to the NIH said on Jun 2, 1994 that it had found no evidence of wrongdoing in studies of fialuridine, or FIAU, an experimental drug for hepatitis B that led to the deaths of 5 participants. The NIH conducted the experiments, but canceled them in Jun 1993

Internists advanced toward a patient care model based on critical, qualitative, and quantitative assessment of clinical care processes and outcomes. The complete internist must consider social context as well as traditional risk factors in promoting the health of patients